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Wolff A, Koray M, Campisi G, Strietzel FP, Lafaurie GI, Beiski BZ, Ekström J. Electrostimulation of the lingual nerve by an intraoral device may lead to salivary gland regeneration: A case series study. Med Oral Patol Oral Cir Bucal 2018; 23:e552-e559. [PMID: 30148471 PMCID: PMC6167107 DOI: 10.4317/medoral.22597] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 06/30/2018] [Indexed: 11/18/2022] Open
Abstract
Background Salivary gland function is controlled by the salivary reflex, whose efferent arm is composed by the parasympathetic and the sympathetic divisions of the autonomic nervous system. Parenchymal injury is the main salivary gland involvement of Sjögren’s syndrome and head and neck radiotherapy, but neural damage has been reported as well. Recently an intraoral device for electrostimulation of the lingual nerve in vicinity to the lower third molar has been introduced. At this point this nerve carries efferent fibers for the innervation of the submandibular, sublingual and several minor salivary glands and afferent fibers of the salivary reflex. Therefore, excitation of these fibers potentially leads to increased secretion of all salivary glands. Thus, the study objective was to assess whether comprehensive neural activation by electrostimulation of the lingual nerve carries the potential to induce the regeneration of damaged salivary glands. Material and Methods The device was tested on three patients with no collectable resting and stimulated secretion of saliva during a double blind, sham controlled period of two months and nine open-label months. Results All three subjects developed the capacity to spit saliva, not only in direct response to the electrostimulation but also after free intervals without electrostimulation. In addition, their symptoms of dry mouth severity and frequency improved. Conclusions This recovery is probably due to the combined effect of increase in secretory functional gland mass and regain of nervous control of the secretory elements and blood vessels. Both are phenomena that would contribute to gland regeneration. Key words:Xerostomia, dry mouth, saliva, electrostimulation, regeneration.
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Affiliation(s)
- A Wolff
- 65 Hatamar St., Harutzim 60917, Israel,
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Yang HM, Kim HJ, Park HW, Sohn HJ, Ok HT, Moon JH, Woo SH. Revisiting the Topographic Anatomy of the Marginal Mandibular Branch of Facial Nerve Relating to the Surgical Approach. Aesthet Surg J 2016; 36:977-82. [PMID: 27025245 DOI: 10.1093/asj/sjw045] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The marginal mandibular branch (Mbr) of the facial nerve is vulnerable to damage during rhytidoplasty, surgical reduction of the mandibular angle, parotidectomy, and excision of the submandibular gland. OBJECTIVES The authors sought to map the Mbr and determine the relationship between the number of Mbr offshoots and the course of the Mbr. METHODS The Mbr was examined in 29 hemifaces from 12 embalmed and 4 fresh cadavers (10 males, 6 females; mean age, 73.7 years). RESULTS The Mbr was located ≤5 mm from the gonion (Go) in 24 of 29 hemifaces (82.8%) and ≤10 mm from the intersection of the facial artery and mandible (ie, FM) in 26 hemifaces (89.7%). In 16 hemifaces (55.2%), offshoots arose from the Mbr inferior to the mandible. The Mbr ran below the Go in 14 hemifaces (48.3%) and ran below FM in 13 hemifaces (44.8%). Except for minute offshoots deep to the platysma, the Mbr was not found to pass >2 cm below the mandible. The mean (± standard deviation) quantity of Mbr offshoots was 1.5 (± 0.6). A greater number of offshoots was associated with a higher likelihood of an inferiorly located nerve. The Mbr proceeded under the lower border of the mandible in 13 hemifaces (44.8%) and reached the mandible at a mean distance of 33.1±5.2 mm anterior to the Go. CONCLUSIONS To avoid damaging the Mbr, surgical maneuvers should be positioned 4.5 cm anterior to the Go and 2 cm below the mandible.
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Affiliation(s)
- Hun-Mu Yang
- Dr Yang is an Assistant Professor, Department of Anatomy, Dankook University College of Medicine, Cheonan, Korea. Dr Kim is a Professor, Department of Oral Biology, Yonsei University College of Dentistry, Seoul, Korea. Dr Park is a Professor, Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea. Dr Sohn is a Professor and Dr Ok is a Researcher, Department of Anatomy, School of Medicine, Chungbuk National University, Cheongju, Korea. Dr Moon is an Assistant Professor, Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan, Korea. Dr Woo is an Associate Professor, Department of Otolaryngology and Institution of Health Science, Gyeongsang National University, Jinju, Korea
| | - Hee-Jin Kim
- Dr Yang is an Assistant Professor, Department of Anatomy, Dankook University College of Medicine, Cheonan, Korea. Dr Kim is a Professor, Department of Oral Biology, Yonsei University College of Dentistry, Seoul, Korea. Dr Park is a Professor, Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea. Dr Sohn is a Professor and Dr Ok is a Researcher, Department of Anatomy, School of Medicine, Chungbuk National University, Cheongju, Korea. Dr Moon is an Assistant Professor, Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan, Korea. Dr Woo is an Associate Professor, Department of Otolaryngology and Institution of Health Science, Gyeongsang National University, Jinju, Korea
| | - Hyung-Woo Park
- Dr Yang is an Assistant Professor, Department of Anatomy, Dankook University College of Medicine, Cheonan, Korea. Dr Kim is a Professor, Department of Oral Biology, Yonsei University College of Dentistry, Seoul, Korea. Dr Park is a Professor, Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea. Dr Sohn is a Professor and Dr Ok is a Researcher, Department of Anatomy, School of Medicine, Chungbuk National University, Cheongju, Korea. Dr Moon is an Assistant Professor, Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan, Korea. Dr Woo is an Associate Professor, Department of Otolaryngology and Institution of Health Science, Gyeongsang National University, Jinju, Korea
| | - Hyun-Joon Sohn
- Dr Yang is an Assistant Professor, Department of Anatomy, Dankook University College of Medicine, Cheonan, Korea. Dr Kim is a Professor, Department of Oral Biology, Yonsei University College of Dentistry, Seoul, Korea. Dr Park is a Professor, Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea. Dr Sohn is a Professor and Dr Ok is a Researcher, Department of Anatomy, School of Medicine, Chungbuk National University, Cheongju, Korea. Dr Moon is an Assistant Professor, Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan, Korea. Dr Woo is an Associate Professor, Department of Otolaryngology and Institution of Health Science, Gyeongsang National University, Jinju, Korea
| | - Hyun-Tae Ok
- Dr Yang is an Assistant Professor, Department of Anatomy, Dankook University College of Medicine, Cheonan, Korea. Dr Kim is a Professor, Department of Oral Biology, Yonsei University College of Dentistry, Seoul, Korea. Dr Park is a Professor, Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea. Dr Sohn is a Professor and Dr Ok is a Researcher, Department of Anatomy, School of Medicine, Chungbuk National University, Cheongju, Korea. Dr Moon is an Assistant Professor, Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan, Korea. Dr Woo is an Associate Professor, Department of Otolaryngology and Institution of Health Science, Gyeongsang National University, Jinju, Korea
| | - Jung Hwan Moon
- Dr Yang is an Assistant Professor, Department of Anatomy, Dankook University College of Medicine, Cheonan, Korea. Dr Kim is a Professor, Department of Oral Biology, Yonsei University College of Dentistry, Seoul, Korea. Dr Park is a Professor, Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea. Dr Sohn is a Professor and Dr Ok is a Researcher, Department of Anatomy, School of Medicine, Chungbuk National University, Cheongju, Korea. Dr Moon is an Assistant Professor, Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan, Korea. Dr Woo is an Associate Professor, Department of Otolaryngology and Institution of Health Science, Gyeongsang National University, Jinju, Korea
| | - Seung Hoon Woo
- Dr Yang is an Assistant Professor, Department of Anatomy, Dankook University College of Medicine, Cheonan, Korea. Dr Kim is a Professor, Department of Oral Biology, Yonsei University College of Dentistry, Seoul, Korea. Dr Park is a Professor, Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea. Dr Sohn is a Professor and Dr Ok is a Researcher, Department of Anatomy, School of Medicine, Chungbuk National University, Cheongju, Korea. Dr Moon is an Assistant Professor, Department of Otorhinolaryngology, Dankook University College of Medicine, Cheonan, Korea. Dr Woo is an Associate Professor, Department of Otolaryngology and Institution of Health Science, Gyeongsang National University, Jinju, Korea
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Erythropoietin Attenuates the Apoptosis of Adult Neurons After Brachial Plexus Root Avulsion by Downregulating JNK Phosphorylation and c-Jun Expression and Inhibiting c-PARP Cleavage. J Mol Neurosci 2015; 56:917-925. [PMID: 25877688 DOI: 10.1007/s12031-015-0543-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 03/09/2015] [Indexed: 01/05/2023]
Abstract
In the present study, the effects of erythropoietin (EPO) on preventing adult neurons from apoptosis (introduced by brachial plexus avulsion) were examined, and the mechanism was analyzed. Fifty injury rat models were established in this study by using micro-hemostat forceps to pull out brachial plexus root from the intervertebral foramen in supine position. These models were divided into EPO group (avulsion + 1000 U/kg subcutaneously on alternate days) and control group (avulsion + normal saline). C5-T1 spinal cord was harvested at days 1, 2, 4, 7, and 14. Compared with the control group, the apoptosis of spinal motoneurons was significantly decreased on days 4 and 7 in the EPO group, which was also approved by TUNEL examination results. The detection of p-JNK and expression of c-Jun and cleavage of cleaved PARP (c-PARP) were also examined by immunohistochemistry and were increased immediately at day 1, and peaked at day 2, day 2, and day 4 in control group, respectively. However, the amounts were decreased and delayed by EPO treatment significantly at the same time points. In conclusion, the apoptosis of adult spinal motorneurons was associated with JNK phosphorylation, c-Jun expression, and caspase activity, and EPO-mediated neuronal protective effect is proved by downregulating the JNK phosphorylation and c-Jun expression and inhibiting of c-PARP cleavage.
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